orgovyx and Xtandi

[shihtzu124]

Is anyone on Medicare taking either orgovyx or Xtandi. If so, is it covered by PArt B or PArt D? We are looking at Wellcare and wondering if it gets decent coverage .

[ToolBeltZia]

Just started Orgovyx. I am on Medicare with Wellcare Value Script. I have a Medicare supplement, not Advantage It is covered, but the first co-pay was $997. And of course the deductible starts anew January 1st. Going to be a pricey little ride.

[dhccpa in reply to ToolBeltZia]

Maybe gets better by 2025? Still learning about those upcoming changes.

[CancerConcierge]

My husband is on Orgovyx and his Part D plan pays for it …. Still expensive even with Part D coverage.

[Murk]

I just signed up with WellCare Part D Supplement Program after confirming that Orgovyx is covered under their standard plan. It's a no brainer since Orgovyx for a 30 day supply is $3,100.00 out of pocket cash expense.

[maley2711 in reply to Murk]

no brainer NOT to use Orgovyx??????

[Murk in reply to maley2711]

Correct!

[dhccpa in reply to Murk]

How much under your plan yearly?

[shihtzu124 in reply to dhccpa]

We have plain Medicare A + B plus D. Our 2024 Wellcare Value Script (PDP) plan D says $2786.20 for the year for Orgovyz. But my husband's RO is recommending 6 months. So who knows.

[dhccpa in reply to shihtzu124]

That amount for a full year sounds "good," but I haven't had to face it yet. Thanks.

[Murk]

Every time I talk to WellCare I get different information and cost data LOL. But they always seem to say that Orgovyx is covered but every every time I get a different cost of the drug...

[Bert47]

In a chat with Wellcare yesterday they told me that the first 30 supply would be $2395.55 and subsequent 30 day refills would be $646.80. This is starting deductible anew in January. Doesn't seem right to me as the deductible in Arizona for next year is $400. I would think the initial 30 day supply should be reduced by the 25% for a Tier 5 drug, after subtracting the $400. They claim not.